5-氨基酮戊酸光动力疗法预防尖锐湿疣复发

目的观察5-氨基酮戊酸光动力疗法(ALA-PDT)对于预防尖锐湿疣复发的作用。方法107例尖锐湿疣患者经CO2激光祛除疣体,并在创面愈合后随机分为二组,治疗组55例在原疣体部位局部外敷10%5-氨基酮戊酸(ALA)霜剂,包括皮损周围1.0～2.0cm,并用薄膜封包3h,再用光动力治疗仪照射,时间为20min/光斑,光斑直径2.0cm,1次/w,连续2次,此后每2～4w随访1次,连续6个月;对照组52例,创面痊愈后,不用任何药物,仅每2～4w随访1次,连续6个月,观察两组治疗区的疣体复发情况。结果治疗组有4例在治疗部位(光斑直径2.0cm范围内)出现疣体,复发率为7.27%,对照组共有35例在治疗范围(直径2.0cm内)出现疣体,复发率为67.30%。结论ALA-PDT对尖锐湿疣复发具有很好的预防作用。     

δ-氨基酮戊酸光动力配合二氧化碳激光治疗复发性尖锐湿疣46例效果分析

目的：观察δ-氨基酮戊酸（ALA）光动力（PDT）配合CO2激光治疗复发性尖锐湿疣的临床疗效。方法：46例复发的尖锐湿疣患者中,对疣体大于0．5cm的先进行CO2激光治疗,再用新鲜配制的20％ALA霜采取局部湿敷或封包方法结合给药,3个小时后用波长为635nm的激光照射,选择输出功率为150mw,根据光斑的大小及照射时间计算激光照射总能量,使其达到100～120J／cm^2,照射时间为20—30分钟。结果：46例患者经过1～3次治疗后,皮损全部清除,患者无感染、瘢痕等不良反应,经过3个月随访有42例（91．3％）患者痊愈,4例（8．7％）患者复发。结论：δ-氨基酮戊酸光动力配合CO2激光治疗复发性CA疗效高,且复发率低,值得临床推广。     

氨基酮戊酸光动力疗法治疗尿道口尖锐湿疣临床疗效观察

目的:了解氨基酮戊酸光动力疗法治疗尿道口尖锐湿疣的疗效和安全性.方法:213例尿道口尖锐湿疣患者采用5氨基酮戊酸生理盐水溶液局部封包3 h后进行光动力学治疗,每周1次,最多治疗3次,疣体消退后再巩固治疗1次.结果:3次治疗后208例患者治愈,治愈率为97.7%.随访6个月,复发17例,复发率为8.2%.不良反应轻微.结论:氨基酮戊酸光动力疗法治疗尿道口尖锐湿疣疗效好,复发率低,不良反应少,是一种理想的治疗尿道口尖锐湿疣的方法.     

卡介菌多糖核酸治疗复发性尖锐湿疣疗效评价

目的:评价卡介菌多糖核酸(BCG-PSN)治疗复发性尖锐湿疣(CA)的临床疗效。方法:82例门诊复发性尖锐湿疣患者随机分为治疗组(44例)和对照组(38例)。治疗组激光去除疣体后采用BCG-PSN肌肉注射,隔日1次,共30次;对照组激光去除疣体后采用胸腺五肽肌肉注射,隔日1次,共30次,均随访1年。结果:治疗组复发率为42.3%,对照组复发率为76.3%。结论:BCG-PSN治疗能降低复发性CA的复发率。     

5-氨基酮戊酸光动力疗法联合CO_2激光治疗复发性尖锐湿疣疗效观察

目的:比较外用药、CO_2激光及5-氨基酮戊酸光动力疗法(ALA-PDT)联合CO_2激光3种方法治疗复发性尖锐湿疣的疗效,探索一种能有效降低尖锐湿疣复发的方法.方法:分别采用外用药、CO_2激光、ALA-PDT联合CO_2激光治疗39例复发性尖锐湿疣患者,并进行回顾性分析.结果:对39例患者随访3～12个月,均先开始外用鬼臼毒素酊治疗,平均41 d在原皮损部位出现新的皮损.复发率为100%.再采用CO_2激光治疗,平均57 d复发,复发率为100%.最后经ALA-PDT联合CO_2激光治疗,复发率降至5.1%(2例),对复发患者再次采用联合疗法治疗1次达痊愈.结论:ALA-PDT联合CO_2激光治疗复发性尖锐湿疣可明显降低复发率(P＜0.01),且安全、耐受性好,无明显不良反应.     

钬激光联合光动力治疗尿道内尖锐湿疣临床疗效观察

目的探讨钬激光联合氨基酮戊酸光动力疗法(ALA-PDT)治疗尿道内尖锐湿疣的疗效及安全性。方法尿道内尖锐湿疣患者60例,随机分为3组。钬激光组20例采用输尿管镜下钬激光汽化疣体。光动力疗法组20例采用光动力疗法每周治疗1次,共治疗3次。钬激光联合光动力疗法组20例,先采用输尿管镜用钬激光汽化疣体,1周后行光动力治疗,每周治疗1次,共治疗3次。比较3组的治愈率、复发率及不良反应。结果术后随访6个月,钬激光组治愈率100%,复发率40%;光动力组治愈率60%,复发率16.67%;联合组治愈率100%,复发率10%。联合组治愈率高于光动力组,而复发率又低于钬激光组,两者差异有统计学意义(P0.05)。光动力疗法不良反应表现为局部皮肤灼热感,无尿道狭窄发生。结论钬激光联合光动力治疗尿道内尖锐湿疣能提高治愈率,有效减少复发率,大大缩短病程。     

棒状光源盐酸5-氨基酮戊酸光动力治疗肛管内尖锐湿疣

目的:评价棒状光源盐酸5-氨基酮戊酸光动力疗法治疗肛管内尖锐湿疣的临床疗效。方法:棒状光源盐酸5-氨基酮戊酸治疗肛管内尖锐湿疣男性患者46例,每周1次,共4次。结果:35例(76.1%)患者疣体完全清除,无感染、溃疡、瘢痕、痔疮病例。随访12周复发5例,复发率为14.3%。疼痛程度可视模拟评分(VAS)为(6.96±1.41)分。结论:棒状光源盐酸5-氨基酮戊酸治疗肛管内尖锐湿疣疗效好,中度疼痛,复发率低,不良反应少。     

儿童尖锐湿疣发病情况分析及5-氨基酮戊酸光动力治疗评价

目的分析儿童尖锐湿疣发病情况,并评价5-氨基酮戊酸光动力疗法治疗儿童尖锐湿疣的临床疗效及安全性。方法回顾性分析2008年1月—2014年6月期间在我科接受5-氨基酮戊酸光动力治疗的24例儿童尖锐湿疣患者,每周治疗1次,连续治疗2~4次,治疗后随访6个月评价复发率和不良反应。结果儿童尖锐湿疣主要由间接接触引起。24例尖锐湿疣患儿5-氨基酮戊酸光动力治疗结束后疣体完全消退,治愈率100%,有3例患儿复发,复发率为12.5%。主要不良反应为照射部位水肿、疼痛、红斑、色素沉着及3岁以下儿童的大便失禁。结论我国儿童尖锐湿疣主要为间接接触感染。5-氨基酮戊酸光动力疗法治疗儿童尖锐湿疣清除率高、不良反应小、耐受性好、复发率低,可作为儿童尖锐湿疣的首选疗法。     

光动力联合CO_2激光治疗尖锐湿疣的复发观察

目的:观察5-氨基酮戊酸光动力(ALA-PDT)联合二氧化碳激光治疗尖锐湿疣的临床疗效。方法:将80例患者随机分为治疗组(33例)和对照组(47例),两组均用CO_2激光清除可见疣体。治疗组再用ALA-PDT治疗,每周1次,连续3次,对照组不加其他治疗。两组均于第一次治疗后的第1、2、3、4、8、12周随访,如有可见疣体,及时用CO_2激光清除。第12周时比较两组的复发情况及不良反应。结果:第12周随访时,治疗组总复发率为9.09%,对照组总复发率为44.68%(χ~2=10.06,P0.05)。两组患者均未发生系统不良反应。结论:ALA-PDT联合CO_2激光治疗尖锐湿疣可以明显降低复发率,患者耐受性好,安全性高。     

光动力疗法和咪喹莫特预防老年男性尖锐湿疣复发的疗效观察

目的比较5-氨基酮戊酸光动力疗法(ALA-PDT)和咪喹莫特对老年男性尖锐湿疣患者经微波治疗后疾病复发率的影响。方法将92例老年尖锐湿疣患者随机分为三组,微波治疗组(A组)、微波联合ALA-PDT组(B组)和微波联合咪喹莫特组(C组)。所有患者予微波祛除疣体,A组34例在创面愈合以后局部不给任何药物治疗;B组26例在原疣体部位及周边1cm范围局部外敷20%5-氨基酮戊酸(ALA)霜剂,并用薄膜封包3h,再用光动力治疗仪照射,时间为20min/光斑,1次/周,连续3次;C组32例创面愈合以后外用咪喹莫特软膏,隔天1次,连用12周。随访6个月,观察复发率及不良反应。结果微波联合ALA-PDT组和微波联合咪喹莫特组治疗后复发率分别为15.38%和21.88%,显著低于微波治疗组(52.94%)(P0.01),但前两者间复发率差异无统计学意义(P0.05)。结论 ALAPDT和咪喹莫特均能有效降低老年男性患者尖锐湿疣微波治疗后的复发,且效果相似。     

ALA光动力治疗鲍温样丘疹病临床研究

目的观察5氨基酮戊酸(5aminolevulinicacid,ALA)光动力疗法(photodynamictherapy,PDT)治疗鲍温样丘疹病的临床疗效。方法治疗组38例采用ALAPDT治疗,每周治疗1次,共治疗4次;对照组15例予以二氧化碳激光治疗。结果治疗组痊愈12例,显效12例,有效率为61.2%,复发2例,复发率16.7%,无明显疼痛、创面等副作用;对照组痊愈9例,显效3例,有效率为80.0%,复发5例,复发率55.5%,15例均有术后明显创面疼痛,8例合并创面感染,9例出现表浅瘢痕。两组之间有效率和复发率无显著性差异(P>0.05)。结论ALAPDT是治疗鲍温样丘疹病的一种安全、有效、无明显痛苦和不良反应的新疗法。     

In vivo fluorescence kinetics and photodynamic therapy in condylomata acuminata

BACKGROUND: Topical application of 5-aminolaevulinic acid (ALA) to condylomata acuminata leads to accumulation of protoporphyrin IX (PpIX); therefore ALA-induced photodynamic therapy (ALA-PDT) appears to be a potential treatment. OBJECTIVES: To investigate in vivo the PpIX fluorescence time course after topical application of ALA in order to determine the optimal time for irradiation, and to assess the efficacy of subsequently performed ALA-PDT. METHODS: Fluorescence kinetics was studied in 12 male patients with condylomata acuminata. Confirmation of diagnosis was established with conventional histology and polymerase chain reaction. Lesions were treated with 20% ALA and irradiated at the optimal time with a dose of 70 J cm-2 or 100 J cm-2 light. An additional session with 100 J cm-2 was administered 1 week later to lesions that persisted. RESULTS: The in vivo study of fluorescence kinetics indicated that the optimal time for irradiation varied among patients from 6 to 11 h. The overall cure rate was 72.9%, 12 months after treatment. CONCLUSIONS: Topical ALA-PDT is a potentially effective treatment for condylomata acuminata.     

外用氨基酮戊酸光动力疗法治疗男性尿道口尖锐湿疣的疗效观察

目的观察外用氨基酮戊酸光动力疗法(ALA-PDT)治疗男性尿道口尖锐湿疣的安全性与临床疗效。方法80例男性尿道口尖锐湿疣患者随机分为ALA-PDT试验组和CO_2激光对照组,1周1次,疗程最多3周。末次治疗后第1周进行疗效评价,第4,8和12周观察复发率及不良反应。结果在末次治疗后1周,试验组和对照组疣体清除率均为100%。试验组治疗后复发率(7.5%)明显低于对照组(40.0%)(P<0.01)。两组均未发生系统不良反应。局部不良反应发生率试验组为10.0%,主要为轻微糜烂;对照组为50.0%,主要为溃疡、疼痛和瘢痕。试验组不良反应发生率明显低于对照组,差异有统计学意义(P<0.01)。结论外用ALA-PDT疗法治疗男性尿道口尖锐湿疣治愈率高,复发率低,安全性好。     

Comparative study of photodynamic therapy vs CO2 laser vaporization in treatment of condylomata acuminata: a randomized clinical trial

BACKGROUND: Most conventional therapies for condylomata acuminata (CA) are traumatic and have high recurrence rates. OBJECTIVES: To investigate the efficacy and safety of topical application of 5-aminolaevulinic acid (ALA) photodynamic therapy (PDT) for the treatment of CA. METHODS: Sixty-five patients with CA were allocated into the treatment (ALA-PDT) group and treated with 20% ALA solution under occlusive dressing for 3 h followed by irradiation with the helium-neon laser at a dose of 100 J cm(-2) and a power of 100 mW. Another 21 CA patients were allocated into the control group and treated with the CO(2) laser. The treatment was to be repeated 1 week later if the lesion was not completely removed after the first treatment. RESULTS: After one treatment, the complete removal rate was 95% in the ALA-PDT group and 100% in the control group. After two treatments with ALA-PDT, the complete removal rate in the treatment group was 100%. The recurrence rate for ALA-PDT group was 6.3% which was significantly lower than that in control group (19.1%, P < 0.05). Moreover, the proportion of patients with adverse effects in the ALA-PDT group (13.9%) was also significantly lower than that in control group (100%, P < 0.05). The side-effects in patients treated with ALA-PDT mainly included mild burning and/or stinging restricted to the illuminated area. CONCLUSIONS: The present study shows that topical application of ALA-PDT is a simpler, more effective and safer therapy with a lower recurrence for treatment of CA compared with conventional CO(2) laser therapy.     

Topical 5-aminolaevulinic acid-photodynamic therapy for the treatment of urethral condylomata acuminata

BACKGROUND: Electrocoagulation and laser evaporation for urethral condylomata acuminata have high recurrence rates and can be associated with urethral malformations. OBJECTIVES: To investigate the effect of photodynamic therapy (PDT) with topical 5-aminolaevulinic acid (ALA) on urethral condylomata acuminata and to examine the histological changes in lesions of condylomata acuminata after ALA-PDT. METHODS: Patients with urethral condylomata (n = 164) were given topical ALA followed by intraurethral PDT through a cylindrical fibre. Patients included 11 individuals with 16 penile or vulval condylomatous lesions which were biopsied before or after treatment; the histological changes were then evaluated by light microscopy and electron microscopy. RESULTS: The complete response rate was 95% and the recurrence rate was 5% after 6-24 months of follow-up. Light microscopy revealed keratinocytes in the middle and upper layers of the epidermis showing marked vacuolation and some necrocytosis 1 and 3 h after PDT. Necrosis in all layers of the epidermis was noted 5 h after PDT. Electron microscopy of keratinocytes revealed distinct ultrastructural abnormalities of mitochondria and the endoplasmic reticulum, and membrane damage. Apoptotic bodies were detected 3 h after PDT and a large number of keratinocytes exhibited necrosis 5 h after PDT. CONCLUSIONS: Results suggest that, compared with conventional therapies, topical ALA-PDT is a simple, effective, safe and well-tolerated treatment for urethral condylomata acuminata that is associated with a low recurrence rate. The mechanism might be the triggering of both apoptosis and necrosis by ALA-PDT in human papillomavirus-infected keratinocytes.     

5-氨基酮戊酸光动力疗法与CO2激光治疗尖锐湿疣疗效观察

目的:观察5-氨基酮戊酸光动力疗法(ALA-PDT)与CO2激光治疗尖锐湿疣的疗效。方法:采用ALA-PDT与CO2激光治疗尖锐湿疣各30例。结果:光动力组患者痊愈率为63.3%(19/30),复发率为15.8%(3/19);CO2激光组痊愈率为100.0%(30/30),复发率为60.0%(18/30)。结论:CO2激光组痊愈率高于光动力组,特别是一次性去除疣体方面;光动力组在复发率及安全性方面明显优于CO2激光组。     

Photodynamic therapy for the treatment of extramammary Paget's disease

BACKGROUND: Surgical and ablative treatment modalities for extramammary Paget's disease (EMPD) have high recurrence rates and can be associated with significant morbidity. OBJECTIVES: To evaluate photodynamic therapy (PDT) for the treatment of EMPD. METHODS: We conducted a retrospective review of notes and histology of five men with anogenital, groin and axillary EMPD treated with PDT at Roswell Park Cancer Institute between 20 April 1995 and 1 February 2001. RESULTS: Sixteen EMPD lesions were treated with topical aminolaevulinic acid (ALA)-PDT. Eleven of these lesions had failed previous Mohs micrographic surgery, excision or laser ablation. When evaluated 6 months after one treatment with ALA-PDT, eight of 16 (50%) sites achieved a complete clinical response (CR); six of eight CRs were in lesions that had failed prior conventional therapies. Three of the eight CRs (37.5%) recurred at 9, 10 and 10 months. One patient who was partially responsive to topical ALA-PDT subsequently received systemic Photofrin(R)-PDT, with a complete clinical and histological response at 1 year. Functional and cosmetic outcome was excellent in all patients. CONCLUSIONS: PDT is an effective treatment for EMPD. Recurrence rates are high with topical ALA-PDT, but comparable with standard therapies. Topical ALA-PDT causes little scarring and is preferred for superficial disease and mucosal surfaces. Systemic Photofrin(R)-PDT may be better suited for bulky disease. While further studies are indicated, PDT is well tolerated and appears to be a useful therapy for EMPD.     

5-氨基酮戊酸光动力疗法治疗尖锐湿疣的临床观察

目的探讨5-氨基酮戊酸光动力疗法(ALA-PDT)治疗尖锐湿疣后的病毒清除及复发情况。方法将90例尖锐湿疣患者随机分为三组,治疗组采用ALA-PDT治疗,CO2激光组采用CO2激光治疗,冷冻组采用液氮冷冻治疗。治疗前后取材,进行荧光PCR检测低危型(HPV6,11)、高危型(HPV16,18)HPVDNA。结果治疗组、CO2激光组及冷冻组HPV清除率分别为86.67%,56.67%和53.33%,经ALA-PDT治疗后HPV清除率较液氮冷冻及CO2激光治疗高,差异有显著性(P<0.05);ALA-PDT治疗组(10.00%)与CO2激光组(36.67%)及冷冻组(40.00%)比较,复发率差异均有显著性(P<0.05)。结论ALA-PDT对尖锐湿疣皮损的治疗和控制HPV的潜伏感染都十分重要。